Impact of dialysis duration and glucose absorption on nutritional indices in stable continuous ambulatory peritoneal dialysis patients.
OBJECTIVE
The presence of comorbidity is a risk factor for both poor nutrition and poor outcome in continuous ambulatory peritoneal dialysis (CAPD) patients. In CAPD specifically, peritoneal glucose load is associated with a possible suppression of appetite, contributing to protein malnutrition. This study sought to explore the factors associated with malnutrition indices in stable peritoneal dialysis patients without significant comorbidity, and to assess the impact of peritoneal glucose absorption on nutrition parameters.


METHODS
This was a cross-sectional observational study.


METHODS
This study took place in the peritoneal dialysis department of a university hospital, and involved outpatients.


METHODS
There were 23 stable, comorbidity-free CAPD patients (9 women), aged 54 +/- 12 years, with a CAPD duration of 28 +/- 25 months (values are mean +/- SD unless otherwise noted).


METHODS
Nutritional status was evaluated by means of anthropometric and serum measurements. A peritoneal equilibration test was performed, and daily glucose absorption was measured. Lean body mass (LBM) was assessed through creatinine kinetics.


RESULTS
A significant impact of CAPD duration was found. Patients in the upper quartile of CAPD duration had worse nutritional parameters compared with the rest of the group: their mid-upper-arm surface area and fat surface area were lower (65 +/- 9 cm(2) vs. 78 +/- 6.2 cm(2) and 16 +/- 5.3 cm(2) vs. 26 +/- 9.5 cm(2), respectively, P < .05), their albumin concentration was lower (36 +/- 0.5 g/L vs. 42 +/- 4 g/L, P < .05), and their cholesterol and triglycerides were lower (3.5 +/- 0.5 vs. 5.2 +/- 1 mmol/L and 1.3 +/- 0.6 vs. 2.3 +/- 1.1 mmol/L, respectively, P < .05). No significant correlations between peritoneal glucose absorption and these indices were found.


CONCLUSIONS
The duration of dialysis treatment, but not peritoneal glucose absorption, is a predictor of malnutrition in stable, comorbidity-free CAPD patients.
Pajek
Jernej
J
Department of Nephrology, University Medical Center Ljubljana, Ljubljana, Slovenia. jernej.pajek@mf.uni-lj.si
Gucek
Andrej
A
Kveder
Radoslav
R
Bucar-Pajek
Maja
M
Kaplan-Pavlovcic
Stasa
S
Bren
Andrej F
AF
D000328:Adult; D000368:Aged; D015897:Comorbidity; D003404:Creatinine / Q000378:metabolism; D003430:Cross-Sectional Studies; D005260:Female; D005947:Glucose / Q000378:metabolism / Q000493:pharmacokinetics*; D006801:Humans; D007408:Intestinal Absorption / Q000502:physiology*; D007676:Kidney Failure, Chronic / Q000378:metabolism / Q000628:therapy; D008297:Male; D044342:Malnutrition / Q000453:epidemiology* / Q000209:etiology; D008875:Middle Aged; D009751:Nutritional Requirements; D009752:Nutritional Status; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000009:adverse effects* / Q000379:methods; D011237:Predictive Value of Tests; D012307:Risk Factors; D012709:Serum Albumin / Q000032:analysis; D013997:Time Factors; D055815:Young Adult
D012709:Serum Albumin; D003404:Creatinine; D005947:Glucose